Above average — CMS composite of the measures below.
The next survey window likely opens around February 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at The Willows At Howell during CMS and state inspections, most recent first.
Improper food storage, temperature control, and sanitation were observed in kitchen areas. Raw pork was stored above pre-sliced packaged meats, raw chicken was stored with cooked chicken in nearby pans, and a refrigeration unit contained a pureed entree at 60 F and shredded cheese at 45 F while the DON was unaware the unit was out of order. Surveyors also observed buildup in the ice machine, microwave, and coffee nozzle, improper drainpipe air gaps, and stacked clear bins with condensation on a dry storage rack.
The facility failed to properly store and label food items, potentially affecting all residents consuming food. Observations revealed uncovered and unlabeled food in the kitchen and resident refrigerator, with some items past their use-by dates. The kitchen manager and a nurse confirmed that these items should have been covered, labeled, and discarded if expired, as per facility policy.
The facility failed to complete quarterly MDS assessments on time for six residents due to staffing issues, particularly the absence of a social worker responsible for certain sections. The assessments were delayed beyond the required timeframe, with some sections not completed until over 120 days. The MDS Coordinator and support nurse acknowledged the delay and cited the need for further training for the new social worker.
A facility failed to provide a resident with timely Notice of Medicare Non-Coverage (NOMNC) and Skilled Nursing Facility Advance Beneficiary Notice (SNFABN). The NOMNC was issued on the resident's last covered day, preventing timely appeal, and the SNFABN was not provided after skilled services ended, leaving the resident uninformed about potential private pay charges.
The facility failed to complete comprehensive MDS assessments in a timely manner for two residents, as required by the RAI manual. For one resident, an annual MDS assessment was delayed, with sections completed by different nurses over several days. Similarly, a significant change MDS assessment for another resident was not fully completed for nearly two months. The delay was attributed to issues with the social worker responsible for certain sections, who required further training. The facility administrator acknowledged the lack of a specific policy for timely MDS completion.
The facility failed to implement proper COVID-19 transmission-based precautions for two residents who tested positive for the virus. Signage outside their rooms did not specify the need for N95 respirators, and staff were observed using inadequate PPE, contrary to facility policy and CDC guidelines.
A resident with a history of substance abuse and various medical conditions was not provided with a written notice of discharge, including the reason for discharge and appeal rights, before being transferred to a hospital. Despite being legally blind, the resident did not receive or have the discharge documentation read to them. The facility's policy of providing a 30-day advance notice was not followed.
The facility failed to follow transmission-based precautions for a resident with MRSA pneumonia, delaying contact isolation for six days after admission. During this period, the resident participated in activities and moved freely within the facility, contrary to the facility's infection control policy. Interviews with the DON and NHA revealed conflicting information about the resident's isolation status, highlighting a deficiency in infection control practices.
Improper Food Storage, Temperature Control, and Sanitation in Kitchen Areas
Penalty
Summary
The facility failed to maintain proper food storage and handling practices in the kitchen and related food service areas. On 03/30/2026 at 8:47 AM, raw pork was observed stored in a pan on the top shelf of a rack in the walk-in cooler, positioned above pre-sliced packaged meats. At 8:49 AM, raw chicken was observed on the bottom shelf of a rack in the walk-in cooler, with stacked metal pans beside it that had a facility label indicating raw chicken; when the lid was removed, cooked chicken was observed inside the stacked pans. The Director of Food indicated they were unaware why the pork was stored there and stated the chicken was for lunch and that it was an educational piece for staff. A poster on the cooler door identified proper food storage and labeling practices, including separation of raw animal foods from ready-to-eat foods and use of first in, first out. The facility also had temperature control and sanitation issues. At 9:02 AM, a two-door refrigeration unit contained liquid egg, pasteurized egg, pureed items, and shredded cheese; a labeled pureed entree felt warm and was found to be 60 F, and shredded cheddar cheese was 45 F. The Director of Food stated the puree had been made the previous day and was unaware the unit was out of order, and food items were removed to be discarded. Additional observations included spotted brown buildup in the ice machine drip panel, food debris along the interior back wall of the microwave in the Cantaloupe cafe, black particulate buildup around the coffee nozzle of the Folgers coffee machine, an improper air gap at the three-compartment sink drainpipe and the two-compartment prep sink drainpipe, and clear bins stacked with condensation on the dry storage rack. The facility also reported using the 2009 FDA Food Code for kitchen policies and had no facility-specific kitchen policies, while a food labeling and dating policy required labels with item name, date and time labeled, use-by date, initials, and secure covering.
Deficient Food Storage and Labeling Practices
Penalty
Summary
The facility failed to properly store and label food items in the kitchen and a reach-in refrigerator, which could potentially affect all residents consuming food at the facility. During a tour of the facility kitchen, several deficiencies were observed, including uncovered and unprotected apple cinnamon desserts and meat patties in the walk-in refrigerator. Additionally, previously cooked personal-sized pizzas were found uncovered and without any dating or labeling. A pan of blueberry dessert was also observed uncovered, with a preparation date that had already passed its use-by date. The kitchen manager acknowledged that these items should have been covered and labeled, and that food past its use-by date should have been discarded. Further observations in a small refrigerator for resident food items revealed an iced coffee drink with no open date, a cup of yogurt past its expiration date, a container labeled as mushroom herb dip that appeared to contain mashed sweet potato with no date, and a salad kit with a use-by date of the same day, but with wilted and brown lettuce. An interview with a nurse confirmed that food in the fridge should be labeled with a resident's name, route, and date it was placed in the refrigerator. The facility's policy on food labeling and dating requires any food product removed from its original container or processed in any way to be labeled with specific information, including item name, date and time labeled, use-by date, and initials of the person labeling the item, and to be securely covered.
Delayed MDS Assessments Due to Staffing Issues
Penalty
Summary
The facility failed to complete quarterly Minimum Data Set (MDS) assessments in a timely manner for six residents, as required by the Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual. The manual stipulates that the Assessment Reference Date (ARD) of the Quarterly MDS should be within 92 days after the ARD of the previous assessment, and the MDS completion date must be no later than 14 days after the ARD. However, the review identified that eight resident MDS assessments were noted as having an MDS record over 120 days, indicating they were either not completed or submitted as required. Specifically, the assessments for residents R8, R16, R17, R40, R41, and R44 were delayed, with some sections not completed until well past the required timeframe. The delay in completing the MDS assessments was attributed to staffing issues, particularly the absence of a social worker responsible for completing certain sections of the assessments. The facility's MDS Coordinator, Nurse 'E', and support nurse, RN 'D', acknowledged the delay and cited the need for further training for the new social worker. Despite being aware of the concerns, the assessments were not completed in a timely manner, as RN 'D' and Nurse 'E' reported they were doing the best they could under the circumstances. The facility did not have a specific policy for timely MDS completion, relying instead on the guidelines provided in the RAI manual.
Failure to Provide Timely Beneficiary Notices
Penalty
Summary
The facility failed to provide a Notice of Medicare Non-Coverage (NOMNC) and a Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNFABN) to a resident, identified as R26, in a timely manner. The NOMNC was issued on the same day as the resident's last covered day, which did not allow the resident or their responsible party adequate time to request an appeal of the non-coverage decision. This lack of timely notification resulted in the resident not being informed of potential private pay charges for continued services at the facility. Additionally, the facility did not provide the SNFABN to R26 after deciding to end skilled services, which is necessary for informing the beneficiary about the potential financial responsibility for services not covered by Medicare. The facility's Past Non-Compliance (PNC) documentation only addressed the absence of the SNFABN and failed to address the issue of the untimely NOMNC notification. The administrator acknowledged the findings during an interview, indicating an understanding of the deficiency.
Failure to Complete Timely MDS Assessments
Penalty
Summary
The facility failed to complete comprehensive Minimum Data Set (MDS) assessments in a timely manner for two residents, R1 and R37, as required by the Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual. For R1, an annual MDS assessment with an Assessment Reference Date (ARD) of 12/12/24 was not completed until 1/21/25, with various sections being completed by different nurses over several days. The last completed MDS assessment for R1 was a quarterly MDS with an ARD of 9/13/24. Similarly, for R37, a significant change MDS assessment with an ARD of 11/14/24 was not fully completed until 1/13/25, with sections being filled out by different nurses over a span of nearly two months. The last completed MDS assessment for R37 was a quarterly MDS with an ARD of 8/19/24. During an interview, RN 'D' and Nurse 'E' acknowledged the delay in completing the MDS assessments and attributed it to issues with the social worker responsible for certain sections of the assessments. The facility had recently lost their previous social worker, and the new social worker required further training on the importance of timely assessments. Despite being aware of the concerns, the staff did not complete the assessments in a timely manner, leading to the deficiency. The facility administrator was informed of these concerns and acknowledged the lack of a specific policy for timely MDS completion, relying instead on the RAI manual guidelines.
Failure to Implement Proper COVID-19 Precautions
Penalty
Summary
The facility failed to properly implement COVID-19 transmission-based precautions for two residents, R6 and R210, who were confirmed positive for COVID-19. Observations revealed that the signage outside R6's room indicated droplet precautions, requiring a surgical mask and eye protection, but did not specify the need for an N95 respirator mask, which is required according to the facility's policy and CDC guidelines. Registered Nurse 'G' was observed exiting R6's room wearing only a surgical mask, and later entering the room with a gown, goggles, gloves, and a surgical mask, but not an N95 respirator mask. The Infection Control Preventionist 'H' confirmed that the signage was not specific to COVID-19 and that staff were expected to follow the facility's policy, which was not adhered to in this instance. Similarly, for resident R210, the signage on the door indicated droplet precautions but did not specify the type of mask, gown, or gloves required. Nurse 'C' confirmed that R210 was on isolation precautions due to a positive COVID-19 test. The clinical records for both residents confirmed their COVID-19 positive status and the need for transmission-based precautions. The facility's failure to provide accurate signage and ensure the use of appropriate PPE for COVID-19 transmission-based precautions led to this deficiency.
Failure to Provide Discharge Notice and Appeal Rights
Penalty
Summary
The facility failed to provide a legally blind resident, identified as R801, with a written notice of discharge, including the reason for discharge, a thirty-day advance notification, and a statement of the resident's right to appeal. R801, who had a history of substance abuse and various medical conditions, was transported to an orthopedic appointment where it was recommended they be transferred to a hospital for further care. However, the resident was not taken back to the facility to receive the necessary discharge paperwork before being transferred to the hospital. Interviews with facility staff, including a Certified Nurse Assistant, Registered Nurse, and Social Workers, confirmed that R801 did not receive the discharge documentation, nor was it read to them, despite their legal blindness. The Nursing Home Administrator and Admission Director later confirmed that R801 was not readmitted to the facility due to behaviors and substance abuse history, although there was no documentation of recent heroin use. The facility's policy requires notifying residents in writing 30 days in advance of a transfer or discharge, which was not adhered to in this case.
Failure to Implement Timely Isolation Precautions for Resident with MRSA Pneumonia
Penalty
Summary
The facility failed to follow their transmission-based precautions for a resident diagnosed with pneumonia due to Methicillin-resistant Staphylococcus aureus (MRSA). The resident was admitted to the facility with MRSA pneumonia, but the contact isolation order was not placed until six days after admission. During this period, multiple nurses documented that the resident did not require isolation, allowing the resident to participate in activities and move freely within the facility. This was contrary to the facility's infection control policy, which required contact precautions for MRSA pneumonia. The discrepancy in documentation and the delay in implementing isolation precautions led to potential exposure of other residents and staff to the infection. Interviews with the Director of Nursing (DON) and the Nursing Home Administrator (NHA) revealed conflicting information regarding the resident's isolation status. The DON stated that the resident was allowed to leave her room under certain conditions, while the NHA mentioned that the resident was placed in contact isolation upon admission. However, the clinical records and staff documentation indicated that the resident was not isolated until six days after admission. The facility's policy required residents with non-contained infections to remain in their rooms, and if they needed to leave, they should wear appropriate protective gear. The failure to adhere to these guidelines resulted in a deficiency in infection control practices at the facility.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Howell
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Medilodge Of Livingston | 1.5 mi | ★★★★★ | 12 | 0 |
| Medilodge Of Howell | 1.9 mi | ★★★★★ | 19 | 0 |
| Wellbridge Of Brighton | 6.6 mi | ★★★★★ | 7 | 0 |
| Caretel Inns Of Brighton | 11 mi | ★★★★★ | 6 | 0 |
| Wellbridge Of Pinckney | 11.9 mi | ★★★★★ | 1 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.